Organization Active NPI

Surgical Group of Gainesville PA

  • Surgery Physician
  • Gainesville, FL
National Provider Identifier
1396737615
Registry record updated Apr 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
ME0060950 Issued in FL
Legal business name
SURGICAL GROUP OF GAINESVILLE PA
Practice address
1143 NW 64TH Ter
Gainesville, FL 32605-4218
Phone
(352) 331-1201
Fax
(352) 331-5273
NPI assigned
Aug 23, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Panagiotis Sarantos, MD
Title
President
Phone
(352) 331-1201

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X ME0060950 FL Primary

Addresses

Primary practice location

1143 NW 64TH Ter
Gainesville, FL 32605-4218

Mailing address

1143 NW 64TH Ter
Gainesville, FL 32605-4218
Phone (352) 331-1201

Other identifiers 1

IdentifierTypeStateIssuer
253318901MedicaidFL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2184735Surgical Group of Gainesville PA1143 NW 64TH Terr, Gainesville, FL 32605Certificate of waiverMay 23, 2028

National Provider Directory

National Provider Directory

Locations

1143 NW 64th Ter
Gainesville, FL 32605
Phone (352) 331-1201

239 SW 7th Ter
Ste C
Gainesville, FL 32601
Phone (352) 338-0045

1143 NW 64th Ter
Ste C
Gainesville, FL 32605

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335312000000",
    "number": "1396737615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1143 NW 64TH TER",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054218",
            "telephone_number": "352-331-1201",
            "fax_number": "352-331-5273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1143 NW 64TH TER",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054218",
            "telephone_number": "352-331-1201",
            "fax_number": "352-331-5273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL GROUP OF GAINESVILLE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-23",
        "last_updated": "2012-04-25",
        "status": "A",
        "authorized_official_last_name": "SARANTOS",
        "authorized_official_first_name": "PANAGIOTIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "352-331-1201",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME0060950",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253318901",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.